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General NPI Number Information
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NPI Number | 1023536414
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Entity Type | Individual
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Provider Name | ALYSSA MALTBY APRN
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Gender | Female
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Dates
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Enumeration Date | 09/06/2017
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Last Update Date | 04/04/2024
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Provider Practice Location Address
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Address Line | 4407 YOAKUM BLVD
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City | HOUSTON
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State | TX
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Zip | 77006-5861
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Country | US
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Telephone | 713-791-2648
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Fax |
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Provider Business Mailing Address
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Address Line | 9904 HIDDEN SHADYBROOK DR
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City | HOUSTON
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State | TX
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Zip | 77080-2210
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | AP135039
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License Number State | TX
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